Urinary Incontinence Treatment: No More Leakage When Coughing or Laughing

What causes urinary incontinence? How are stress incontinence (coughing) and urge incontinence (not reaching the toilet in time) treated? Expert guide on TOT surgery, laser treatment and Kegel exercises.

Don’t Restrict Your Social Life, Be Free

Do you involuntarily leak urine when you laugh, sneeze, or lift a heavy bag? Or do you dribble before reaching the toilet due to a sudden urge? If your answer is yes, then you are facing the problem of Urinary Incontinence (urine leakage), which affects millions of women and men worldwide.

Many people accept this as a ‘natural consequence of ageing’ or ‘the price of giving birth’. However, urine leakage is not a fate; it is a treatable condition. Whether through surgical methods, medication, or new-generation laser technologies, it is possible to achieve dryness and regain your confidence.

In this guide, you will find information to help you determine exactly what type of problem you have and the most up-to-date treatment options.

What is Urinary Incontinence?

Urinary incontinence is the involuntary leakage of urine due to loss of bladder control. This condition is not only a medical issue but also a social and hygienic problem. The individual may be bothered by odour, be forced to use pads constantly, avoid going out, and reduce their water intake (which can lead to further complications).

To address this issue, we must first ‘Know Our Enemy.’ This is because not all urinary incontinence is the same, and treatments can vary significantly.

Types of Urinary Incontinence: Which One Do You Have?

The treatment plan is based entirely on this distinction.

A. Stress Urinary Incontinence

This is the most common type. Here, the word ‘stress’ does not refer to psychological stress, but rather to an increase in abdominal pressure.

Symptoms: Leaking a small amount of urine when coughing, sneezing, laughing, lifting heavy objects, climbing stairs, or jumping.

Cause: Weakening of the pelvic floor muscles that support the bladder and loss of support for the urethra.

Treatment: Usually surgical (TOT/TVT) or laser. Medication is not very effective.B. Urge Incontinence

Also known as ‘Overactive Bladder’ among the general public.

Symptoms: A sudden, intense urge to urinate and leakage before reaching the toilet. The ‘keyhole syndrome’ (leaking while entering the house and inserting the key into the keyhole) is typical.

Cause: Involuntary contraction of the bladder muscles without conscious control from the brain.

Treatment: Typically involves medication, Botox, or lifestyle changes. Surgery is not the first option.

C. Mixed Type

Symptoms of both stress and urge incontinence are present. The patient both leaks when coughing and cannot reach the toilet in time.

D. Overflow Incontinence

This is commonly seen in men with an enlarged prostate. The bladder cannot empty completely, becomes full to capacity, and leaks due to overflow.

Causes: What Causes Urinary Incontinence?

Anatomical and hormonal causes are particularly prominent in women:

Pregnancy and Childbirth: Vaginal (normal) deliveries, giving birth to large babies, or difficult deliveries can tear or weaken the pelvic floor muscles.
Menopause: The oestrogen hormone maintains the tightness of the tissues surrounding the urinary tract. When oestrogen decreases during menopause, the tissues loosen and leakage begins.
Obesity: Excess weight increases intra-abdominal pressure, putting constant pressure on the bladder.
Constipation: Chronic straining weakens the pelvic muscles.
Smoking: Causes chronic coughing, triggering stress-type leakage.
Previous Surgery: May occur after hysterectomy in women or prostate surgery in men.

Non-Surgical Urinary Incontinence Treatments

If the prolapse is mild or you are not suitable for surgery, these methods are used.

A. Kegel Exercises (Pelvic Floor Training)

These exercises aim to strengthen the muscles that support the bladder and urinary tract..How to do it? While urinating, suddenly stop and release. Those are the correct muscles you are contracting. Throughout the day (when not in the toilet), exercise these muscles in sets by squeezing for 5 seconds and relaxing for 5 seconds. When done regularly, it provides 50-60% improvement.

B. Laser Treatment for Urinary Incontinence (Vaginal Laser)

It is the most popular treatment in recent years. It is particularly effective for stress-related incontinence.

Method: Laser beams applied to the vagina trigger collagen production in the area. The tissues tighten and provide support to the urinary tract.
Advantages: It is painless, does not require anaesthesia, and can even be performed during a lunch break. It yields successful results in 3 sessions.

C. Medication Treatment

Used only for urge incontinence. Medications that inhibit bladder contractions (anticholinergics) provide relief for the patient.

Surgical Treatment: The Definitive Solution (TOT and TVT Procedures)

In stress urinary incontinence (leakage when coughing), the most effective and permanent solution is surgery, as there is an anatomical defect (prolapse/loosening). Traditional open surgeries are now rarely performed.

TOT (Transobturator Tape) and TVT Suspension SurgeriesThese procedures are known as ‘Suspension Surgery’.

How is it performed? A very small incision of 1-2 cm is made through the vaginal route. A synthetic band (mesh) is placed under the urinary tract (urethra) to support it. This band lifts the urinary tract upwards like a hammock.

Duration: The procedure takes only 15-20 minutes.

Success Rate: Over 90%.

Recovery: The patient is discharged the same day or the next day. There is no visible scar.

Injection Treatments (Fillers)

Bulking agents are injected around the urethra to increase its volume, thereby narrowing the canal. This is a temporary solution and may need to be repeated.

Treatment for Urinary Incontinence in Men

In men, incontinence usually occurs after prostate surgery (especially cancer surgery) due to damage to the sphincter (valve mechanism).

Mild Cases: Kegel exercises and medication.
Moderate Cases: Male Sling surgery.
Severe Cases: Artificial urinary sphincter (artificial valve) implantation.

What Should Be Done to Prevent Urinary Incontinence?

Lose Weight: Losing just 5-10% of your body weight can significantly reduce bladder pressure.
Cut Down on Caffeine: Coffee and tea are diuretics and stimulate the bladder.
Stop Smoking: Preventing coughing fits protects the pelvic floor.
Avoid Constipation: Eat a high-fibre diet.
Don’t Stop Drinking Water: Drinking too little water concentrates urine, which irritates the bladder and causes you to urinate more frequently. 1.5-2 litres of water per day is ideal.

Frequently Asked Questions (FAQ)Question: Does urinary incontinence recur after surgery? Answer: The success rate of suspension surgeries such as TOT/TVT is very high and the results are permanent. However, if the patient gains excessive weight or lifts very heavy objects, there may be a risk of recurrence years later.

Question: How soon after surgery can I return to my daily life? Answer: You can return to your normal life 1-2 days after sling surgery. However, it is recommended that you avoid heavy lifting and sexual intercourse for 1 month.

Question: Can herbal remedies cure urinary incontinence? Answer: Although some supplements, such as pumpkin seed oil, are said to be good for the bladder muscles, no plant can correct stress incontinence (prolapse), which is an anatomical disorder. Medical support is essential to avoid wasting time.

Question: Can it occur in women who have not given birth? Answer: Yes. Urinary incontinence can occur even in women who have not given birth, particularly in those with genetically weak connective tissue, those who engage in strenuous sports, or those with chronic asthma/coughing.

Result: Dryness and a Sense of Security Are in Your Hands

Urinary incontinence is not something to be ashamed of; it is a medical condition that needs to be treated, just like diabetes or high blood pressure. You don’t have to be confined to pads, avoid travelling, or hold back your laughter.

If you leak when you cough, a 15-minute suspension procedure, or if you can’t make it to the toilet in time, the right medication can completely transform your quality of life.

Do yourself a favour and don’t put off dealing with this issue. Consult a urology specialist to plan your treatment.